<%@ page contentType="text/html;charset=UTF-8" language="java" %>
<%@include file="../../common/taglibs.jsp"%>
<%@include file="../../common/_head.jsp"%>
<html>
<head>
</head>
<body>
<div class="layui-form" lay-filter="layuiadmin-form-data" id="layuiadmin-form-data" style="padding: 20px 30px 0 0;">
    <input style="display: none" name="userId" id="userId" value="">
    <div class="layui-form-item">
        <label class="layui-form-label">提现积分</label>
        <div class="layui-input-block">
            <input type="number" name="credit" id="credit" disabled required lay-verify="required" placeholder="积分" autocomplete="off" class="layui-input">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">提现金额(元)</label>
        <div class="layui-input-block">
            <input type="number" name="amount" id="amount" required lay-verify="required" placeholder="积分" autocomplete="off" class="layui-input">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">支付宝姓名</label>
        <div class="layui-input-block">
            <input type="number" name="alipayName" id="alipayName" required lay-verify="required" placeholder="支付宝姓名" autocomplete="off" class="layui-input">
        </div>
    </div>
    <div class="layui-form-item">
        <label class="layui-form-label">支付宝账号</label>
        <div class="layui-input-block">
            <input type="number" name="alipayNo" id="alipayNo" required lay-verify="required" placeholder="支付宝账号" autocomplete="off" class="layui-input">
        </div>
    </div>
    <div class="layui-form-item layui-hide">
        <button class="layui-btn" lay-submit="" lay-filter="data-submit" id="data-submit">提交</button>
    </div>
</div>

<script src="<%=path%>/js/usermanage/user/submitCleanWithdraw.js"></script>
</body>
</html>
